title: Exploring predictors of mesh exposure after vaginal prolapse repair.
abstract: OBJECTIVE
  To evaluate clinical, demographic, and surgical factors that may be associated with mesh exposure after vaginal repair of pelvic organ prolapse (POP).
  
  
  METHODS
  Records of women who underwent POP repair with Elevate or Prolift were retrospectively reviewed. Body mass index (BMI), prolapse grade, smoking history, diabetes, steroid and estrogen use, parity, compartment repaired, concurrent hysterectomy, operative time, postoperative pain, change in hemoglobin (ΔHgb) and other characteristics were evaluated for associations with mesh exposure.Categorical variables were examined using Pearson χ test where appropriate, or the Fisher exact test was used. The continuous variables were examined using Wilcoxon rank tests. A multivariable logistic regression analysis was completed to examine predictors of mesh exposure. All analyses used SAS for Windows version 9.2 (Cary, NC).
  
  
  RESULTS
  Three hundred thirty-five women underwent repair from 2006 to 2011. Vaginal mesh exposure was identified in 27 (8.1%) of the 335 women. Patients with exposure had longer median follow-up than the group with no exposure (357 vs 145 days; P = 0.0003). The median time to exposure was 96 days (15-1129 days). Mesh exposure was associated with lower BMI (25.2 ± 2.5 vs 27.4 ± 5.1; P = 0.020) and greater ΔHgb (-3.7 ± 1.7 mg/dL vs -2.5 ±1.3; P = 0.0011). Change in hemoglobin decreased over time (P = 0.0005). Exposure rates also decreased over time (17% in 2005 to 12% in 2006, then 5%-8% in 2006-2011) but were not statistically significant (P = 0.49).
  
  
  CONCLUSIONS
  In this study, vaginal mesh exposure was only associated with ΔHgb and lower BMI.
authors.affiliation: William Beaumont School of Medicine, Oakland University, Royal Oak, MI, USA.
authors.forename: Larry T
authors.initials: LT
authors.lastname: Sirls
authors.forename: Gregory P
authors.initials: GP
authors.lastname: McLennan
authors.forename: Kim A
authors.initials: KA
authors.lastname: Killinger
authors.forename: Judith A
authors.initials: JA
authors.lastname: Boura
authors.forename: Melissa
authors.initials: M
authors.lastname: Fischer
authors.forename: Pradeep
authors.initials: P
authors.lastname: Nagaraju
authors.forename: Kenneth
authors.initials: K
authors.lastname: Peters
mesh_terms: D000368:Aged; D015992:Body Mass Index; D002983:Clinical Competence; D005260:Female; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D008875:Middle Aged; D018579:Patient Selection; D010818:Practice Patterns, Physicians'; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D013526:Surgical Mesh / Q000009:adverse effects / Q000706:statistics & numerical data*; D014596:Uterine Prolapse / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery*
chemical_list: D006454:Hemoglobins